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Karnataka
By Our Staff Correspondent
When Mangalore is gearing up to hold the fourth annual State-level neonatology conference organised by the Indian Academy of Paediatrics (IAP) and the National Neonatology Forum (NNF) on Saturday, the city has something to show to these bodies. The first neonatal unit in the State, initially called premature nursery, was established by the Paediatrics Department of Kasturba Medical College (KMC) in the government Lady Goschen Hospital in the early Sixties. This was also the beginning of the cooperation between the Government and the private sector in healthcare. The first postgraduate course in Paediatrics was started in the State in the KMC in 1967. This gave an impetus to the highly specialised care of neonates, B. Shantaram Baliga, one of the leading lights of neonatal care in Mangalore, recalls. The unit at the Lady Goshen Hospital started with box-type incubators brought from Ohio, U.S., and cradles with facility to keep hot-water bags. This unit has saved the lives of hundreds of babies. The lowest weight among the babies saved here was 800 grams. Amidst scarcity of resources, the unit took care of several pre-term and sick babies. These incubators worked for more than 15 years. There was the concept of asepsis those days. Sick babies and babies born outside were cared for in a separate room called sick nursery. Procedures such as exchange transfusion were effectively carried out. The changes in neonatal care began with starting of the neonatal unit in Fr. Muller's Hospital in the early Eighties and the Mangalore Nursing Home in the latter half of that decade, Dr. Baliga says. Umesh Nayak, paediatric anaesthetist, ventilated the first baby in Fr. Muller's Hospital in 1986. In 1989, a neonatal unit with sophisticated ventilator facility started functioning in the TMA Pai Rotary Hospital at Bejai. Today, many paediatricians in the city are capable of neonatal ventilation. In the Nineties, neonatal care improved manifold. Delivery room care and the entire perinatal care changed for the better, Dr. Baliga says. Collective and effective mode of treatment of neonates was achieved. The opening of the Neonatal Intensive Care Unit (NICU) in Lady Goshen Hospital created a history of sorts in private participation in government hospitals. The NICU provided latest neonatal care facilities to the poor segment of society. Medical practitioners, postgraduate medical students, and the hospital administration could jointly work to create one of the best NICUs of the State in the government sector. In the late Nineties, level II basic NICUs were opened at Puttur, Surathkal, and Moodbidri which helped in bringing down neonatal mortality rate to a new low. Dr. Baliga says these advanced facilities have contributed only a little in lowering perinatal mortality. Overall progress and increased female literacy rates are its major determinants. This conclusion is based on the fact that the perinatal mortality rate dropped from 40.5 per 1,000 in 1990 to 30 per 1,000 in 1998. Further reduction in the rate to 19 per 1,000 in 2001 needs to be analysed.
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